ANGELA BOOMSMA (NPI# 1598163560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598163560 |
| Entity Type | Individual |
| Full Name | ANGELA BOOMSMA |
| Credential | FNP-BC |
| Practice Address |
6501 S Promontory Dr Chicago IL 60649 |
| Mailing Address |
6501 S Promontory Dr Chicago IL 60649-1002 |
| Practice Telephone | 7733636700 |
| Mailing Telephone | 7733636700 |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2019-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209-012206 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209-0112206 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6501 S Promontory Dr, Chicago, IL 60649 | 7733636700 | |
| 7110 W 127th St Ste 130, Palos Heights, IL 604631579 | 7089236300 | 7089236303 |
| Street Address |
6501 S PROMONTORY DR |
| City | CHICAGO |
| State | IL |
| Zip Code | 60649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447261524 | Jennifer Lynn Miller | Pediatrics | 6501 S Promontory Dr, Chicago, IL 60649-1003 | 2006-08-11 |
| 1154920122 | Saja Froukh | Dietitian, Registered | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2020-10-21 |
| 1982201463 | Leilani Reyes | Nurse Practitioner | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2020-10-07 |
| 1417572603 | Mixi Lopez-corbin | Social Worker | 6501 S Promontory Dr, Chicago, IL 60649-1003 | 2020-06-12 |
| 1639798242 | Erika Joy Meier | Dietitian, Registered | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2020-04-14 |
| 1033757349 | Arianna Timko | Counselor | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2019-12-17 |
| 1992347637 | Allison Rosen | Occupational Therapist | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2019-10-15 |
| 1780236687 | Andrea Rehr | Physical Therapist | 6501 S Promontory Dr, Chicago, IL 60649-1003 | 2019-07-10 |
| 1821562810 | Haleigh Alexandria Nierman | Occupational Therapist | 6501 S Promontory Dr, Chicago, IL 60649-1003 | 2019-01-14 |
| 1700350766 | Codi Lesniewski | Physical Therapist | 6501 S Promontory Dr, Chicago, IL 60649-1002 | 2019-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386250199 | A Safe Haven, L.L.C. | Clinic/Center | 7342-46 S Kingston, Chicago, IL 60649 | 2020-09-17 |
| 1477178713 | Angela K Coleman | Counselor | 1955 E 71st Street, Chicago, IL 60649 | 2020-06-12 |
| 1245880715 | Familydoc Urgent Care LLC | Clinic/Center | 7201 S Stony Island Ave, Chicago, IL 60649 | 2019-09-17 |
| 1912498668 | Venessel N/a Woodson I | Radiology | 7674 S. Southshore Dr #1n, Chicago, IL 60649 | 2018-05-29 |
| 1689117764 | Susana Jimenez | Occupational Therapy Assistant | 2649 E. 75th St, Chicago, IL 60649 | 2016-11-22 |
| 1063863579 | Regina Whittmon | Driver | 7808 S Coles Ave Apt 3, Chicago, IL 60649 | 2016-06-27 |
| 1174912356 | Montsho Gallardo | Doula | 7653 S Coles Ave, Chicago, IL 60649 | 2015-01-12 |
| 1780922120 | April Ong | Physical Therapist | 6700 S Oglesby Ave, Apt 1906, Chicago, IL 60649 | 2013-01-18 |
| 1114288594 | Days Adult Day Care and Personal Care Providers Inc | Clinic/Center | 2455 E 75th St, Chicago, IL 60649 | 2012-06-02 |
| 1891064887 | Kevin Forrest | Occupational Therapist | 2425 E. 71st Street, Chicago, IL 60649 | 2011-12-20 |
| Find all providers in zip 60649 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
| 1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
| 1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
| 1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
| 1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.